Greenhaven Place Independent Lvg and Assisted Lvg

Type of visit: Required - 1 Year

On 12/30/25 at 10:30am Licensing Program Analyst (LPA) Kevin Gould arrived at Greenhaven Place Assisted living for the purpose of conducting a required 1 year annual inspection. LPA met with Administrator, Brittany Andrews and together conducted a tour of the facility. LPA and Administrator evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Dec 30, 2025

Type of visit: Case Management - Deficiencies

On 10/28/25 at 2:35pm, Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management deficiencies inspection at Greenhaven Place to address concerns regarding incident report dated 10/24/25 for reported medication violations. LPA met with administrator Brittany Andrews and together discussed the incident report received by the department. Review of incident indicates there was an unaccounted for narcotic that was supposedly administered to a resident that was not in the facility at the time the medication was documented as administered by S1 (see confidential names list, LIC 811 dated 10/28/25). Per S1 written statements regarding the unaccounted for narcotic. In S1's written statements they state that they are currently on a prescribed narcotic and could not fully remember her shift and goes on to state they cannot recall most of their shift and were "out of it" and could not provide adequate statements as to why medication was documented as administered when the resident was not present and the medication was allegedly placed in the medication destruction box. Facility Administrator has suspended S1 while an investigation is being conducted. Family of affected resident notified and Law enforcement was contacted. based on the written statements obtained by the department, per the California Code of Regulations, Title 22, the following deficiency is cited. Exit interview conducted and a copy of this report and appeal rights were left at the facility.the state’s words, verbatim · CDSS document, Oct 28, 2025

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.58(a)(2) · Plan of correction due date: Oct 29, 2025

Engaged in conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility, or the people of the State of California as evidenced by S1 documenting a narcotic medication was administered to a resident not at the facility at the time of administration and conducting mediation administration while under the influence of a narcotic which poses an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Oct 28, 2025

Plan of correction: Facility has agreed to conduct in person medication administration and resident rights training for all staff members who assist residents with medication administration. All training will be in person and conducted by a qualified individual to conduct said training.

Allegation investigated: Sexual Abuse: Staff member sexually assaulted resident.

Licensing Program Analysts (LPAs) Kevin Gould and Cynthia Tamayo made an unannounced inspection to the Greenhaven Place RCFE on 2/20/25 at 9:00am to conclude the investigation of the above allegation and to deliver the findings. LPAs met with administrator, Brittany Andrews and together discussed the investigation details. Based on the interviews conducted during the investigation process and statements obtained during the investigation process, the department was unable to corroborate the allegations. The department obtained records for the alleged victim R1 (see confidential name list LIC-811 dated 2/20/25) including but not limited to Personnel Report (LIC 500), Current Client Roster, Incident report dated 10/11/24, admission agreement, face sheet ID information, Physician's report (LIC-602), pre placement appraisal, Mini cog dated 3/19/24, fall risk assessment, needs and services plan (initial and most recent), MARS from September and October 2024. Report Continued on LIC 9099-C. Unsubstantiated Additionally the department conducted interviews with alleged victim, R1 who expressed confusion, disorientation of time and place and the reason for her most recent hospitalization. R1 did not provide any substantive statements to the department and refused to discuss the allegations. The department conducted interviews with three other residents and five staff members. All parties interviewed denied ever witnessing any inappropriate behaviors by staff members or other residents. A forensic examination of R1 was conducted and the results of the examination found no evidence of sexual assault. The department also obtained a written statement from caregiver S1, who matched the description of the alleged abuser, stating they were not at work on the days the allegation allegedly took place and provided written statements that R1 would often refuse care from the staff member S1 and preferred assistance from female staff members. S1 denied the allegations. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of Sexual Abuse are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies is cited per California Code of Regulations, TITLE 22. Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Feb 20, 2025 · control 27-AS-20241016095558

Type of visit: Required - 1 Year

On 1/29/25 at 9:00am Licensing Program Analyst (LPA) Kevin Gould arrived at Greenhaven Place Assisted living for the purpose of conducting a required 1 year annual inspection. LPA met with Administrator, Brittany Andrews and together conducted a tour of the facility. LPA and Administrator evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA measured the water temperature in several rooms which have their own water heaters, temperatures measured at 118, 118, 113, 115, 122, 123, and 135 degrees F. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. LPA Requested the following documents for facility file: LIC 308 Designation of Facility Responsibility, LIC 500 personnel report, LIC 9020 client roster and current administrator certificate. Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jan 29, 2025

Allegation investigated: ) Facility does not provide itemized billing statements. 2) Staff do not take resident's vitals as per care plan. 3) Facility does not have an administrator on the premises a sufficient number of hours. 4) Unlocked door presents a safety hazard. 5) Facility was unable to provide power during a power outage.

Licensing Program Analysts (LPA) Kevin Gould made an announced inspection to the Greenhaven Place Independent and Assisted Living on 3/8/24 at 9:15am to conclude the investigation of the above allegations and to deliver the findings. LPA Gould met with administrator, Morgan Whinery and together discussed the investigation details. Based on the interviews conducted during the investigation process and statements obtained during the investigation process, LPA Gould was unable to corroborate the allegations. LPA reviewed resident's records and including billing statements from October 2023 to present. LPA reviewed resident evaluation and corresponding levels of care fees that were provided to LPA and available to all residents and authorized representatives. LPA and department have determined the documentation met all title 22 regulations for billing requirements and development process for evaluating levels of care. the allegation regarding billing statements have determined to be unsubstantiated. As apart of the review process LPA did not observe any written agreements for daily vitals documentation or observed any billing for said services. Report Continued on LIC 9099-C. Unsubstantiated Staff interviewed provided statements to LPA that a vitals program was considered but never implemented and no resident was ever charged for the service. LPA observed no physician's request for documentation of daily vitals. LPA reviewed staff records and did observe that there was an administrator or their designated substitute present at the facility for the amount of hours needed to meet the needs of residents. LPA observed that the designated substitute also obtained administrator certification and was present at the facility in the administrators absence. Regarding the allegations of unlocked doors. the facility's approved plan of operation does not indicate the facility will lock all exterior doors. Based on interviews conducted at the facility the identified doors are only unlocked from 8am to 5pm and there have been no reported issues with unauthorized individuals entering the facility or the unlocked doors posing a danger to residents. This facility does not have a memory care program. LPA reviewed records that could not corroborate a specific power outage as the reporting party could not provide specifics in terms of exact dates/times. Per the complaint and title 22 regulations there is no requirement that the facility maintain power at all times only that there be an emergency plan of operation and if the plan was implemented. staff interviewed were able to describe emergency plan of operation and actions taken in a power outage. There are no requirements for the facility to have a backup power generator. Per the reporting party the power outage was minimal and power restored in a few hours. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of Physical Plant and Other are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies is cited per California Code of Regulations, TITLE 22. Exit interview was conducted with the licensee. Appeal Rights were issued, and a copy of this report was left at the home.the state’s words, verbatim · CDSS document, Mar 8, 2024 · control 27-AS-20231013091842

Type of visit: Required - 1 Year

On 1/19/24 at 12:45pm Licensing Program Analyst (LPA) Kevin Gould arrived at Greenhaven Place Independent and Assisted Living for the purpose of conducting a required 1 year annual inspection. LPA met with Administrator, Morgan Whinery and together conducted a tour of the facility. LPA and Administrator evaluated the physical plant to ensure the health and safety of the residents in care. Areas inspected are including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room and outdoor areas. LPA observed the facility to be free of odor, clean and in good repair. LPA observed that all rooms are equipped with the required furniture and sufficient lighting throughout the facility. LPA Gould observed one housekeeper closet that was not locked and is required to be locked due to contents of closet. LPA measured the water temperature, temperature measured at 111 degrees F which meets the 105-120 degree Fahrenheit regulation. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA notes the facility had the required carbon monoxide detectors. First aid kit was checked and is complete. LPA observed centrally stored medications secure from residents. Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jan 19, 2024

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 10/5/23 at 10am to conduct an investigation of a medication error. LPA met with Bailey Leach, Business Office Director and stated the purpose of the visit. Community Care Licensing (CCL) received an Unusual Incident/Injury Report incident report (LIC624-SIR) dated 9/15/23 regarding resident #1 (R1). The SIR indicated that on 9/12/23, R1 received medication that should have been administered at 11:30am but instead it was administered at 2pm. R1 should have received eye drops during the 2pm medication pass but did not receive that. In essence, Staff #1 (S1) inadvertently switched the medications and times that should have been administered. The responsible parties of R1 and S2, was present with R1 at the time when the medications were questioned by S2. S2 contacted the doctor and placed R1 on 72hr alert charting. There were no adverse reactions to the medication error. S1 was removed from the Medication Technician position and will be re-trained with shadowing. LPA interviewed S1-S3, R1, and responsible parties of R1. Based on the documents submitted to CCL and interviews, the preponderance of evidence standards has been met. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 809D during this visit. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed. The Administrator designee was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights. Exit interview conducted and a copy of todays’ report provided.the state’s words, verbatim · CDSS document, Oct 5, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(c)(2) · Plan of correction due date: Oct 5, 2023

Incidental Medical and Dental Care If the resident's physician has stated in writing that the resident is unable to determine his/her own need for nonprescription PRN medication but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the resident with self-administration, provided all of the following requirements are met: Once ordered by the physician the medication is given according to the physician's directions. This requirement is not met as evidenced by: Medication was not administered as prescribed to R1 Based on documentation and interviews which confirmed the medication error occurred. This violation poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Oct 5, 2023

Plan of correction: Licensee has submitted proof that additional training was provided to S1. POC Cleared prior to today’s visit